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[EviLore]

Digest article for the layperson

Source paper

Aerobic exercise – any activity that gets your heart pumping harder – improves mood, anxiety and memory. It can help people with major depressive disorder, bipolar disorder and anxiety disorder. Now there’s evidence, from a randomised controlled trial published in Frontiers in Psychiatry, that a programme of regular aerobic exercise also reduces psychopathology in people diagnosed with schizophrenia. And it seems to have a particular impact on so-called “negative” symptoms, such as apathy and loss of emotional feeling, which are not improved by standard drug treatments.

“[W]hile antipsychotics [drug treatments] are essential in treating schizophrenia, interventions other than antipsychotic treatment…may be needed to achieve better outcomes,” write the authors of the new study, led by Peng-Wei Wang at Kaohsiung Medical University Hospital in Taiwan.

The researchers recruited 62 patients, all of whom had received a diagnosis of schizophrenia at least a year ago, and whose antipsychotic medication dosage had been stable for at least three months. These participants were randomly allocated into either an aerobic exercise group (30 minutes of “vigorous” aerobic exercise, taking into account each participant’s maximum heart rate) or a control group who performed stretching exercises (25 minutes of flexibility, toning and balance exercises), with a goal of five sessions a week, for 12 weeks. Not all participants managed to stick to the minimum requirement of three sessions per week for the full three months. But 24 in the exercise group and 22 in the control group did complete the study. (There were no significant differences in gender make-up, age of onset of schizophrenia, or mean dosage of antipsychotics between the two groups.)

A psychiatrist who was blind to the group allocations used a standard schizophrenia symptom evaluation scale to interview and evaluate all the participants at the start of the study; at the end of the 12 week intervention; and again, three months on. The control group showed no improvements in positive (e.g. hallucinations and delusions) or negative symptoms, or general psychopathology, during the intervention or the follow-up period. But for the aerobic exercise group, it was a different story.

Over the 12-week intervention, their overall psychopathology and level of negative and positive symptoms decreased. Three months later, these improvements had been maintained (and, in the case of negative symptoms, actually continued to improve). Also, the more severe their negative symptoms and general psychopathology at the start of the study, the bigger their improvements by the end.

“These results imply that [aerobic exercise] could be a good non-pharmacotherapeutic intervention for antipsychotic-treated patients with schizophrenia,” the researchers conclude.

Fascinating.

Basically, per the above, schizophrenia patients need to be treated with antipsychotic meds to control their paranoid delusions, hallucinations and usually other meds to tranquilize them as necessary to stabilize them overall, but meds can't address their lows properly. You'd have to stim them or take them off tranquilizers/stabilizers, etc. and that would have already been deemed too dangerous. So they're stuck with extreme negative states of apathy and meaninglessness that are probably being made more difficult to cope with by the mood stabilizers and tranquilizers and being kept in safe environments as necessary etc.

Chinese researchers here investigated possible non-drug pathways to supplement the necessary antipsychotic meds since more meds were a logical dead end for the most part (better meds that control the psychosis with less side effects will likely continue to help over time though). Lo and behold, turns out *everyone* benefits from regular exercise, whether you're bummed out about a breakup, struggling with major depressive disorder and/or anxiety disorder, bipolar, or even schizophrenic. Schizophrenic patients who stuck with the clinical trial's exercise plan had less severe positive/manic/high states, particularly less severe negative/depressed/low states that stayed less severe after the exercise plan concluded, and overall improvement to their neuroses.


Everyone: get regular exercise. It's clearly a crucial component of staying centered and living a more positive life under just about any circumstances, but it's all the more important when you're hitting deep, depressive lows.

 

[Greedings]

Exercise seems to do a lot of things that are super beneficial.

It helps with practically every mental illness, it helps with diabetes, it helps with many kinds of inflammation. What's causing it we don't really know yet, but one potential idea is in the form of myokines, a kind of hormone released by your muscles, often in response to exercise.

In the last few years there has been some cool discoveries with myokines, and I'm sure there's more to come. On example showed that a particular myokine - Metrnl was able to influence immunity directly, although the scientists looked at how this regulated metabolism (another fascinating part of science which I'm currently working on - how immunity controls whole body metabolism).

There's also the idea that merely changes in energy balance can drive drastic changes in a cell. A lot of chemicals used in generating energy are also used to control gene expression, linking cell action directly to energy availability. Very cool idea.